Reverse shoulder arthroplasty for the treatment of three-part and four-part proximal humeral fractures in the elderly.

Autor: Ross M; Brisbane Hand and Upper Limb Research Institute, Brisbane, QLD, Australia; Orthopaedic Department, Princess Alexandra Hospital, Brisbane, QLD, Australia; School of Medicine (Orthopaedic Surgery), The University of Queensland, St Lucia, QLD, Australia. Electronic address: research@upperlimb.com., Hope B; Brisbane Hand and Upper Limb Research Institute, Brisbane, QLD, Australia; Orthopaedic Department, Princess Alexandra Hospital, Brisbane, QLD, Australia., Stokes A; Grace Orthopaedic Centre, Tauranga, New Zealand., Peters SE; Brisbane Hand and Upper Limb Research Institute, Brisbane, QLD, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia., McLeod I; Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK., Duke PF; Brisbane Hand and Upper Limb Research Institute, Brisbane, QLD, Australia.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2015 Feb; Vol. 24 (2), pp. 215-22. Date of Electronic Publication: 2014 Aug 29.
DOI: 10.1016/j.jse.2014.05.022
Abstrakt: Background: The purpose of this study was to review the survivorship, radiologic and clinical outcomes of reverse shoulder arthroplasty (RSA) used for the treatment of 3-part and 4-part proximal humeral fractures in the elderly.
Methods: Between 2003 and 2009, 29 shoulders in 28 elderly patients (87% female) with a 3-part or 4-part fractures were managed with RSA in Brisbane, Australia. Clinical and radiologic outcomes of this continuous cohort were retrospectively reviewed at an average follow-up of 54.9 months. Average age at surgery was 79 years. Survivorship and radiologic outcome assessment for all patients was undertaken. Seven patients died, and 1 was unavailable for clinical review, leaving 21 shoulders in 20 patients available for clinical review.
Results: There were no revisions of the reverse prosthesis. Mean average pain was 2.19 of 100 (standard deviation [SD], 6.97). Mean American Shoulder and Elbow Surgeons score was 89.3 (SD, 13.65). Mean normalized Constant score was 88.03 (SD, 11.24). Grade 1 scapular notching was observed radiologically in 4 shoulders. A scapular spur was observed in 7 shoulders. Class 1 heterotopic ossification was seen in 4 shoulders. Nonprogressive lucent lines were seen in 2 shoulders. Nonprogressive radiolucency was observed around the superior screw in 3 shoulders. No loosening of the glenoid baseplate or of the humeral component was observed. There was 1 complication of an axillary nerve palsy, which spontaneously resolved by 12 months after surgery.
Conclusion: RSA using the shoulder technique described in this series provides good clinical and radiologic outcomes in elderly patients with 3-part and 4-part fractures.
(Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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